title: Postoperative detection of circulating tumor cells predicts tumor recurrence in colorectal cancer patients.
abstract: BACKGROUND
  Circulating tumor cells are thought to play a crucial role in the development of distant metastases. Their detection in the blood of colorectal cancer patients may be linked to poor outcome, but current evidence is controversial.
  
  
  METHODS
  Pre- and postoperative flow cytometric analysis of blood samples was carried out in 76 colorectal cancer patients undergoing surgical resection. The EpCAM/CD326 epithelial surface antigen was used to identify circulating tumor cells.
  
  
  RESULTS
  Fifty-four (71%) patients showed circulating tumor cells preoperatively, and all metastatic patients showed high levels of circulating tumor cells. Surgical resection resulted in a significant decrease in the levels of circulating tumor cells. Among 69 patients undergoing radical surgery, 16 had high postoperative levels of circulating tumor cells, and 12 (75%) experienced tumor recurrence. High postoperative level of circulating tumor cells was the only independent variable related to cancer relapse. In patients without circulating tumor cells, the progression-free survival rate increased from 16 to 86%, with a reduction in the risk of tumor relapse greater than 90%.
  
  
  CONCLUSIONS
  High postoperative levels of circulating tumor cells accurately predicted tumor recurrence, suggesting that assessment of circulating tumor cells could optimize tailored management of colorectal cancer patients.
authors.affiliation: Division of Surgical Oncology-"F. Magrassi - A. Lanzara" Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, c/o II Policlinico, Edificio 17, Via Pansini 5, 80131, Naples, Italy, gennaro.galizia@unina2.it.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Galizia
authors.forename: Marica
authors.initials: M
authors.lastname: Gemei
authors.forename: Michele
authors.initials: M
authors.lastname: Orditura
authors.forename: Ciro
authors.initials: C
authors.lastname: Romano
authors.forename: Anna
authors.initials: A
authors.lastname: Zamboli
authors.forename: Paolo
authors.initials: P
authors.lastname: Castellano
authors.forename: Andrea
authors.initials: A
authors.lastname: Mabilia
authors.forename: Annamaria
authors.initials: A
authors.lastname: Auricchio
authors.forename: Ferdinando
authors.initials: F
authors.lastname: De Vita
authors.forename: Luigi
authors.initials: L
authors.lastname: Del Vecchio
authors.forename: Eva
authors.initials: E
authors.lastname: Lieto
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000097:blood* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D013997:Time Factors